Provider Demographics
NPI:1679527345
Name:JOSHI, MANUJA (MD)
Entity Type:Individual
Prefix:
First Name:MANUJA
Middle Name:
Last Name:JOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:484-884-0617
Mailing Address - Fax:484-884-0628
Practice Address - Street 1:1431 NURSERY ST STE 101A
Practice Address - Street 2:
Practice Address - City:FOGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18051-1612
Practice Address - Country:US
Practice Address - Phone:610-336-8260
Practice Address - Fax:610-336-8269
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I50352Medicare UPIN
PA099077Medicare ID - Type Unspecified